First experience with multifocal toric IOL Triphobic HD implantation for refractive purposes in a patient with high hyperopia

    Abstract

    V.V. Teplovodskaya, E.A. Kokaeva

    First experience with multifocal toric IOL Triphobic HD implantation for refractive purposes in a patient with high hyperopia

    S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation

    Relevance. Modern cataract surgery has acquired a distinct refractive focus, which is particularly relevant given population aging and the growing need for presbyopia correction. Patients now expect not only cataract removal but also complete spectacle independence, including cases of high ametropia where laser correction is contraindicated. Multifocal intraocular lenses (MIOLs) address this need by providing high visual acuity at all distances. However, the correction of high hyperopia using MIOLs remains understudied, despite these patients’ strong potential for successful implantation. Key contributing factors include: early-onset presbyopia, anatomical features (short axial length, narrow anterior chamber angle) predisposing to angle-closure glaucoma, and high motivation for spectacle independence. In this context, the 2023-approved trifocal IOL Triphobic HD True Trifocal Hydrophobic MICL (EYEOL UK LIMITED, UK) with its extended diopter range (up to +40.0 D sphere and +6.0 D cylinder) is of particular importance. The limited publications on its use underscore the relevance of this clinical case.

    Purpose. To analyze clinical and functional outcomes of Triphobic HD Toric True Trifocal Hydrophobic MICL implantation in a patient with high hyperopia and corneal astigmatism. Material and

    Methods. We present a case of a 42-year-old male with OU high hyperopia and corneal astigmatism, OS amblyopia. History: multifocal spectacle correction and exhibiting refractive instability. The patient underwent refractive lens exchange with Triphobic HD Toric True Trifocal Hydrophobic MICL implantation.

    Results. The postoperative course was uneventful. At 1-month followup, visual acuity was: OD: 1.0 (distance), 1.0 (66 cm), 0.5 (33 cm); OS: 0.7 (distance), 0.6 (66 cm), 0.4 (33 cm); OU: 1.0 (near/intermediate distance). The patient reported minor optical phenomena without discomfort. VF-14 satisfaction score was 100 points.

    Conclusion. This analysis demonstrates the efficacy and safety of Triphobic HD Toric True Trifocal Hydrophobic MICL implantation in high hyperopia. The results confirm modern MIOLs’ potential in refractive surgery by providing: high functional visual acuity at all distances, significant quality-of-life improvement, stable postoperative outcomes. Key success factors included: comprehensive diagnostic evaluation using modern equipment, precise IOL power calculation, strict surgical protocol adherence, personalized treatment approach

    Keywords: cataract surgery; high hyperopia; multifocal IOL; presbyopia